Inspection on 16/12/08 for Avondale Residential Care Home

This inspection was carried out on 16th December 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Avondale Residential Care Home 12/01/07

Avondale Residential Care Home 16/02/06

Avondale Residential Care Home 30/08/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Avondale Residential Care Home 45 Norton Road Stourbridge West Midlands DY8 2AH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Lancashire     Date: 1 6 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Avondale Residential Care Home 45 Norton Road Stourbridge West Midlands DY8 2AH 01384442731 01384235590 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Kelly Bate Type of registration: Number of places registered: Stoneleigh Care Homes Ltd care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Avondale, which is on a main road near Stourbridge, is a fifteen bedded home accommodating older people. The home has been adapted and extended for this purpose from a traditional property in its own grounds with mature gardens and car parking available. The facilities include 15 single bedrooms (10 with en-suite), two communal lounges, a dining area, one assisted bathroom, one shower and four communal toilets. A shaft lift is also available for access to the first floor. This home is registered for personal care only. There is a clear policy on not offering emergency care. The fees are available on application to the home. 0 Over 65 15 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited this home on a weekday without telling anyone that we would be arriving. The purpose of the visit was to see how the home is meeting key National Minimum Standards. Before the visit we had received information from the manager about the running of the home. On the day, we spoke to the manager, staff and some people who live at the home. We looked round the building and into several bedrooms. We examined records which the manager is required to keep, including records about the peoples needs and preferences, safety, menus, staff rotas, medication, staff recruitment and training, complaints and minutes of meetings. We looked at the systems which the home has for monitoring its performance and at the results of questionnaires completed by people who live there. We used this information to write this report. Care Homes for Older People Page 5 of 25 Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 7 of 25 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into this home are provided with the necessary information to make an informed choice. Assessments and visits to the home ensure that people know, before they move in, that their needs can be met by the home. Evidence: The manager informed us in the AQAA that people considering moving into the home are provided with information about the home and are invited to visit to decide whether or not they feel comfortable in the home and amongst other residents. Their needs are assessed and this process involves the person and other relevant family members. We sampled files, including those of people who had most recently been admitted to the home and found that they contained detailed assessments of their needs and preferences. These are used to form the basis of the care plans. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social needs are set out in a care plan so that they can be met by staff. People are treated with respect and their privacy and dignity are maintained. They are protected by the homes practices in relation to the storage and administration of medication. Evidence: We saw care plans on the three files which we sampled. These contained details of each persons health and social care needs and how they were to be met by staff. These plans had been reviewed on a monthly basis and updated as necessary. These plans provide good details for staff about how to care for the people who live in the home, including peoples choices and preferences. We saw risk assessments covering areas such as pressure areas, nutrition, and falls. There are also details of hospital visits and care provided by other health professionals such as opticians, dentists and district nurses. People choose their General Practitioner and the home has people registered at seven different surgeries. Care Homes for Older People Page 12 of 25 Evidence: There is suitable, secure storage for the medication in the home. Several staff are trained to administer medication and their names are listed in the medication folder. We looked at the records of when medication has been given by staff and these were up to date, with no gaps. We saw good records of medication in the home and good instructions for staff about when to give it to the people who live there. The pharmacist makes regular checks on the homes medication and the last report did not identify any problems. We saw staff treating the people who live in the home with respect and being helpful. Staff take care when laundering peoples clothes and everyone looked well presented. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples lifestyles in the home match their preferences and suitable activities are arranged. They are encouraged to maintain significant relationships with people in the community and they receive a variety of nutritious meals which meet their needs and take account of their preferences. Evidence: The manager told us that people are encouraged to make decisions about whether or not they wish to participate in acitities. There is a quiet sitting room where people read or chat. The television is not left on all day in the main room. Some people prefer to spend time in their own rooms. Some go out with relatives or other visitors. The activities book shows that people have recently taken walks in the park, been out to lunch and enjoyed a magic show in the home. On the morning of the inspection people were doing crafts. We saw plans for a Christmas party involving friends, relatives and a vocalist. The records show that peoples preferences and needs in terms of food are recorded at the time of admission and updated when further information is known. Peoples Care Homes for Older People Page 14 of 25 Evidence: weights are recorded and monitored as necessary and suitable action is taken when there are problems. The menus show meals which appear to be well balanced in terms of nutrition and to meet peoples needs. The manager told us that the home used the services of a nutritionist earlier in the year and some improvement have been made to menus since then. These include the inclusion of more omega three in peoples diets. More use is made of oily fish and lentils. Pasta options and smoothies have been added to the menus and additional fruit is offered. For example, fresh fruit is used instead of pie fillings and orange juice and fresh fruit are offered at breakfast. The small number of people in this home means that meals can be provided to meet peoples particular needs and tastes. Specific diets are provided for people who need fat free, diabetic and gluten free diets. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements to ensure that people are protected, including the arrangements for handling complaints. Evidence: We saw the homes complaints procedure and the details for contacting the owner and the CSCI are clearly displayed in the entrance area. There is also a copy of the procedure in the guide for people who live in the home. There is a book for recording any complaints received and any action taken but there have been no recent complaints. The people who live in this home are able to express their opinions and we heard of examples changes which have been made as a result of these. The home has policies and procedures on adult protection and whistle-blowing. All staff are trained in awareness of adult protection issues and the action to take should they need to make a report. Checks are made through the Criminal Records Bureau on all staff and we saw that there is a thorough recruitment system which includes taking up references. These measures ensure that people in the home are well protected. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, clean and safe environment which meets their needs. Evidence: The building is clean and well maintained throughout, with no unpleasant odours. Since the last inspection, the home has been refurbished both internally and externally with furniture replaced, new carpets throughout, complete repainting and newly landscaped garden. A handrail has been added at the front entrance so that it is now safer. There are two communal rooms, so residents can choose to sit in a quiet room. There are sufficient WCs and bathrooms which are kept clean. People may choose to use the accessible shower on the ground floor or the assisted bath on the first floor. We sampled several bedrooms were homely with plenty of light and many personal items. The garden is accessible and has suitable furniture so that people can enjoy sitting in the garden in the warmer weather. There are suitable arrangements for the storage of cleaning materials and other chemicals. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home are cared for by sufficient numbers of staff who are well trained and competent to do their jobs. They are protected by the homes recruitment practices. Evidence: We sampled staff files and saw that they are recruited through a standard process and all appropriate checks are made, including taking up references and checking with the Criminal Records Bureau. There is a basic induction during the first week of employment. Further skills are covered during the induction period. There is a checklist for monitoring this period and monthly appraisals are carried out for the first three months of employment. The rotas show a good level of staffing which exceeds the minimum level required.The manager told us that she prefers to use the services of regular staff and the homes own bank staff to cover in times of staff shortage, so that there is greater consistency for people who live in the home and no use has been made of agency staff recently. There is a senior member of staff on each shift. All staff receive induction training and in-house training is supplemented by outside trainers who lead the mandatory courses. There is a good system for ensuring that all staff renew basic training and receive opportunities to develop their skills and knowledge in other areas. In addition to basic training, various members of the team have recently received training in diabetes care, dementia care, healthy eating, incontinence, falls Care Homes for Older People Page 19 of 25 Evidence: prevention, challenging behaviour and deprivation of liberty. Over 50 of the staff team have achieved NVQ level 2 or above. All staff receive regular supervision and appraisal. A questionnaire is distributed prior to appraisals and the manager told us that this helps to keep the sessions focused. We saw minutes of staff meetings. In addition, the owner and manager are available for informal discussion on a daily basis. The home has the Investors in People Award. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home which is run in their best interests and where there are good systems for maintaining the quality of care. Their financial interests are safeguarded and their health, safety and welfare is promoted and protected. Evidence: The Registered Manager is suitably qualified and experienced to run the home. She has completed the Registered Managers Award. The rotas show that there are clear lines of responsibility in the staff team and suitable arrangements for cover in the absence of the manager. We saw the homes quality assurance system which is used to maintain the standard of care. This involves questionnaires which are sent to all interested parties including the residents and visiting professionals. The records show that the owner makes regular visits to the home on an announced and unannounced basis and writes an account of his findings. The manager told us that she reviews the policies and procedures regularly. The home has an annual development plan and a business plan. The manager told us that the home does not act as an appointee or Care Homes for Older People Page 21 of 25 Evidence: agent for any people who live there. Service users make their own arrangements for the handling of their finances. However, the home does look after some small amounts of spending money on behalf of people. There are procedures which govern the handling of this money. We saw that individual amounts of money are stored securely, with full records of deposits and withdrawals. The manager checks the records on a regular basis and signs to indicate this. Inventories of peoples property are completed at the time of admission. We saw that the home has a written statement of the policy, organisation and arrangements for maintaining safe working practices. All accidents are recorded. The manager supplied us with dates were provided for the full range of safety checks on equipment in and services to the home. The training records show that staff are provided with training in safe working practices and equipment for infection control is freely available at the areas of frequent use. We saw risk assessments in relation to the individual service users, the building, working practices and fire. These are reviewed and updated on a regular basis. We sampled the risk assessments and the safety records and found these to be up to date and in good order. The physical environment is very well maintained and any possible hazards, such as steps, are well marked. Staff are also aware of the need to provide verbal warnings to visitors. There are aids and adaptations in bathrooms and WCs to enhance personal safety. The manager told us that there are frequent visits by the handyman, who attends to minor repairs and decorates all areas on a regular basis. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!